In general, you can do pretty much everything you did before you were transplanted. Most practices, including ours, encourage the patient to shampoo and clean the hair and scalp the next day, preferably under our supervision at the office. Approximately half of our patients take us up on this service. If your shower is a fairly strong one, then I advise having a washcloth over the hair as you wash it. Or you can simply use a small pan with a handle and pour water over your head with that and not let the shower directly hit the grafts. Most fine-spray showers are not going to harm the grafts at all. The most important thing with those first few shampoos is to not let a comb or brush bristles scrape across one of the small scabs at the ends of the grafts. This could dislodge one of them. The grafts are remarkably stable in their new homes. The “blood glue” of the plasma, the factors in plasma and blood that encourage things to clot and stick together, helps stabilize that graft in the narrow recipient site. As long as the depth of the site is the same as the length of the graft, then there is sufficient room for the graft to be under the skin, with its epidermis (skin) layer at or just above that of the surrounding skin.
Regarding other aspects of scalp care, camouflage products can be used starting the second or third day in my opinion. If there are sufficient remaining native hairs in the area, Toppik is a good choice, though a little messy and expensive. It has tiny micro-fibers which cling to the existing hair, making it look twice as thick. Dermmatch is another good alternative, which paints the underlying skin, but doesn’t come off in the rain, etc – only in the shower with soap the next day. You can use whatever your favorite shampoo and/or conditioner is. When working it in, it is important to use the balls of your fingers to do so, as this is gentlest. You can use a blow dryer to help style your hair, but be sure to keep the brush “up in the treetops” and not let it dip down to skin level and catch any grafts.
You can wear a hat (baseball cap) if you want. Hard hats, ski and motorcycle helmets are probably not a good idea that first 7-10 days. Hairpieces should not be worn at all for that first week, and then they should be converted to clips as an attachment method, with attention to rotating the position of the clips frequently, so that the same hair isn’t being tugged on all the time, or you could develop little bald areas.
The donor scar will be crusty usually. Putting some ointment such as Bacitracin or vaseline on it at night can keep it soft and less itchy, but is a little messy on the pillow. For the graft sites themselves, some use a frequent saline spray to keep the grafts moist. Others use Graftcyte, a copper peptide spray and application pads, which in our experience greatly cuts down on the redness (inflammation) and scabbing. Applying a vaseline base product each night to the scabs is one of the best ways to speed up the falling off of the scabs.
With regard to when the best time to have the next haircut or color ones hair, I generally recommend waiting at least two weeks, so that the crusting along the donor scar is gone and evidence of surgery is really not present for the stylist to see.
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